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前程加卡铂后程野中野加速超分割放射治疗食管癌90例临床观察

Clinical observations on 90 patients with esophageal carcinoma treated by radiotherapy of forecourse with adjuvant chemotherapy and late course with accelerated hyperfraction radiotherapy by fieldinfield

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【作者】 张淑芬单荣棠于保拴许秀峰陈保平代占英

【Author】 Zhang Shufen,Shan Rongtang,Yu Baoshuan,at al. The Affiliated Hospital of Hebei Medical College for Health Staff,Baoding 071000

【机构】 河北职工医学院附属医院

【摘要】 目的探讨前程加卡铂后程野中野加速超分割放射治疗食管癌的疗效。材料与方法自1991年10月至1993年6月对90例食管癌病人随机分常规放射治疗组(常规组)和前程加卡铂后程野中野加速超分割放疗组(前化后超组)各45例。两组临床资料相近,具备可比性。常规组每周照5次,每次2Gy,总量60~70Gy;前化后超组前3周放疗同常规组,配合卡铂每周两次,每次100mg,总量600mg。第4,5周在原照射野中设小野(同病变长度),每次1.5Gy,每周5次,上午照大野,下午照小野,总量5周65Gy,其中大野5周50Gy,小野后两周15Gy。结果放疗结束时X线改善前化后超组病灶全消和消失1/2以上86.7%(39/45),常规组57.8%(26/45)(P<0.01)。1,2,3,4年生存率分别为75.6%、53.3%、42.2%、33.3%和55.6%、31.1%、20.0%、15.6%。前化后超组明显好于常规组(P<0.05)。结论前程配合卡铂后程大野套小野加速超分割放射治疗能显著提高食管癌1,2,3,4年生存率,病人能顺利完成疗程。

【Abstract】 Purpose To evaluate the effects of radiotherapy of forecourse with adjuvant chemotherapy and late course of accelerated hyperfraction radiotherapy by fieldinfield for esophagus carcinoma.Materials and Methods From October,1991 to June, 1993, 90 patients with esophagus carcinoma were randomized into two groups: Conventional fraction radiation (CFR) group (45 cases) and fore course combined chemotherapy followed by late course of accelerated hyperfraction radiotherapy by fieldinfield (FCLHR) group (45 cases). The clinical materials of the two groups were similar. Patients in CFR group received 2 Gy/F, 5 fractions/week with the total dose of 60~70 Gy/6~7 weeks. Patients in FCLHR group received 30 Gy/3 weeks in conventional fields , concomitantly with chemotherapy (carboplantin 100 mg/a day iv drip, 2 times/a week with the total dose 600 mg) followed by accelerated hyperfraction irradiation (2 fraction/a day with 4~6 hour interval, 2 Gy/f in large field with total dose of 20 Gy/2 weeks,1.5 Gy/F in small field with 15 Gy/2 weeks) during late 2 weeks of the course. The total dose was 65 Gy/5 weeks in FCLHR.Results The complete response and partial response rates were 86.7% (39/45) in FCLHR group,and 57.8% (26/45) in CFR group, respectively, at the end of the course (P<0.01). The 1,2,3,4year survival rates were 75.6%, 53.3%, 42.2%, 33.3% in FCLHR group and 55.6%, 31.1%, 20.0%, 15.6% in CFR group, respectively (P<0.05).Conclusion The 1,2,3,4year survival rates of patients with esophagus carcinoma can be improved by FCLHR. This treatment method is tolerable.

  • 【文献出处】 中华放射肿瘤学杂志 ,CHINESE JOURNAL OF RADIATION ONCOLOGY , 编辑部邮箱 ,1998年02期
  • 【分类号】R735.1
  • 【被引频次】8
  • 【下载频次】18
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